What Can Be Done For My Very Short Chin?

Q: Dr. Eppley, I am interested to know what can be done for my very short chin. I don’t know if I just need an implant or whether the jaw bone has to be moved. If you can answer a few questions for me I would appreciate it very much. 1) What is the biggest chin implant in terms of maximal horizontal projection? 2) How much can a sliding genioplasty move the chin forward? 3) Can sliding genioplasty be combined with an implant? 4) Can the entire lower jaw be moved without changing my bite? 5) How do you correct chin deficiencies larger than 10 mm? 6) How do you correct vertical deficiencies? 7) Does the implant feel natural and is there any risk of shifting after surgery?

A:  The person with a very short chin poses challenges that often neither a standard chin implant or a sliding genioplasty can ideally solve. In answer to your questions:

1) The maximum horizontal projection for most chin implants is 12 mms.

2) How much a sliding genioplasty can advance the chin depends on the thickness of the mandibular symphyseal bone. That could translate into a 10 to 12mm chin point forward movement.

3) Yes. An implant can be overlaid in front of a sliding genioplasty to gain more horizontal projection or width.

4) No. The mandibular body and ramus can not be changed without carrying the attached teeth with it also, thus changing the occlusal relationship to the upper teeth. By definition, jaw advancement surgery changes the bite.

5) Options include a custom designed chin implant or a sliding genioplasty with an implant placed in front of it.

6) Vertical chin deficiences require a custom implant and are a component of every horizontal chin deficiency greater than 10mms. When the chin is that short it indicates there is an overall jaw shortness.

7) The implant will feel like bone and is screwed into place to prevent the postoperative risk of shifting.

Dr. Barry Eppley

Indianapolis, Indiana